Evaluation of Naloxone Uptake Disparities Among Harm Reduction Clients in Rhode Island: A Deeper Dive Using...

Although opioid overdose deaths decreased between 2022 to 2024, racial and ethnic disparities persisted during this time. The goal of this analysis was to explore disparities in naloxone uptake by racial and ethnic identity and harm reduction supply preference. This article builds upon prior work and disaggregates race and ethnicity categories that were previously aggregated due to small numbers.

Clients were divided into three mutually exclusive groups based on the type of harm reduction supplies they requested: 1) those who requested injection supplies only, 2) those who requested smoking supplies only, and 3) those who requested both injection and smoking supplies. We calculated descriptive statistics and odds ratios to investigate racial and ethnic disparities in naloxone uptake.

Overall, Black and Hispanic clients were significantly less likely to receive naloxone compared to their White counterparts. Racial and ethnic disparities in naloxone uptake varied after accounting for supply preference. The clearest racial and ethnic disparities were observed among clients who requested smoking supplies.

It is important to consider multiple factors when designing harm reduction and overdose prevention interventions, including racial and ethnic identity, culture, preferred substance, and preferred route of administration. People with lived experience should continue to be included when designing interventions. Given the rapidly changing nature of the illicit drug supply and the emergence of novel substances, anyone who uses illicit substances is at risk of an opioid overdose. Harm reduction agencies should continue to educate stimulant users about their risk of opioid overdose and the benefits of naloxone.